Mississippi’s worsening health outcomes and rising insurance costs were front and center Wednesday at the state Senate’s Insurance Study Committee, where health leaders urged lawmakers to act to shore up access to care.
State Health Officer Dr. Daniel Edney described a long-term decline in health that has depressed the state’s population.
He said Mississippi’s mortality rate has exceeded the U.S. average since 1950; if the state had matched national health outcomes, roughly 280,000 more Mississippians would be alive today.
Factoring in premature deaths among infants, children and young adults, that shortfall climbs above 300,000 — roughly the size of an additional congressional district, he said.
Edney noted that deaths outpaced live births in 2023 and warned that access to care — not just insurance coverage — drives these trends. Rural transportation barriers and shrinking provider networks limit access, he said, and the federal marketplace subsidies adopted during COVID helped narrow coverage gaps but are slated to expire. Without them, Edney warned, the number of uninsured will grow.
“As a state, if we could improve health the way we’ve improved education, we would reduce poverty,” Edney told the committee. He urged lawmakers to fully fund Medicaid ahead of the 2026 legislative session, saying the program is the primary financial support for many hospitals and rural care providers.
While he stopped short of endorsing Medicaid expansion, he argued that strengthening the program makes fiscal sense because of the federal match.
Dental leaders pressed a parallel case for oral health. Dr. Charles Belknapp, president of the Mississippi Dental Association, said oral care is integral to overall health but dental insurers often exclude higher-cost services and lack transparency on how premium dollars are spent. Inflation has raised operating costs for dental practices, Belknapp said, while reimbursement rates have lagged.
Belknapp asked the Legislature to require dental benefit transparency reporting modeled on a law passed in Louisiana in July. Eight other states have similar rules, he noted.
Current figures, he said, show wide variation in the share of premiums returned as care — from roughly 23 percent to 90 percent across plans — and his group advocates for a 90 percent “dental loss ratio” target to ensure premiums fund patient care rather than excessive overhead.
Insurance Commissioner Mike Chaney warned that if federal tax credits end, Mississippi could gain 200,000 uninsured residents, increasing uncompensated emergency-room care and risking hospital closures. That threat, he said, would pressure an already fragile system.
A lobbyist for the Mississippi Association of Health Plans, Drew Maddox, outlined the market forces behind premium growth: specialty medications, an aging population, chronic disease, higher labor costs after the pandemic, and increased use of GLP-1 drugs — prescribed for diabetes but now widely used for weight loss.
Maddox said long-term GLP-1 use in non-diabetic patients may yield negative outcomes and stressed that family and group plans are experiencing the fastest rate increases.
Pharmacy benefit managers (PBMs) also drew scrutiny. Independent pharmacist Michael Jones described steep clawbacks and delayed rate adjustments that force pharmacies to fill prescriptions at a loss.
He said independent pharmacies in many towns have closed; Vicksburg now has two independents where once there were five. Jones urged lawmakers to consider reforms similar to Alabama’s law that prevents PBMs from reimbursing pharmacies below Medicaid rates.
Lawmakers signaled openness to several reforms, including greater transparency for dental insurers and PBMs and fixes to emergency-transport billing that could lower costs. But stakeholders differed on direct price controls. Maddox said insurers oppose government intervention in drug pricing.
Committee members left with a clear message: lawmakers will need to weigh funding for Medicaid, regulatory transparency for dental plans and PBMs, and targeted policy changes if Mississippi hopes to reverse its health and population trends.